THE FEMALE infant shown in Figure 1, Figure 2, and Figure 3 was born at 345/7 weeks' gestation to a 31-year-old, gravida 4, para 1, mother. The 2 previous pregnancy losses were by early spontaneous miscarriage and by elective termination, respectively. This pregnancy was significant for the diagnosis of severe microcephaly by ultrasonographic scan at 285/7 weeks' gestation. The amniotic fluid revealed normal female chromosomes and the culture was negative for cytomegalovirus, herpes virus, and varicella. There was no notable family or medical history.
At birth, her weight was 2014 g; length, 43 cm (both were between the fifth and 10th percentile, respectively); and head circumference, 25 cm, which was significantly below the fifth percentile, corresponding to the mean for 28 weeks' gestation. The infant had deep scalp rugae, a prominent occipital bone with reduced cranial height, no palpable fontanelles, palpable ridges over the suture lines, and a normal